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espanolIntroduccion. La infeccion asociada al cateter urinario es responsable de hasta un 30% de las infecciones nosocomiales. Al respecto, se ha descrito el uso de intervenciones no farmacologicas durante la insercion del cateter urinario para reducir la frecuencia de infecciones asociadas. Objetivo. Evaluar la seguridad y la efectividad de intervenciones no farmacologicas durante la insercion del cateter urinario disenadas para reducir el riesgo de infeccion en adultos inmunocompetentes. Materiales y metodos. Se realizo una busqueda en las bases de datos MEDLINE, Embase y LILACS. Se incluyeron ensayos clinicos aleatorizados que compararan el uso de intervenciones no farmacologicas con el uso de placebos, el uso de intervenciones farmacologicas o la ausencia de intervencion durante la insercion del cateter. Resultados. Se encontraron ocho estudios (8 718 participantes). Con base en la evidencia encontrada (baja y muy baja calidad segun la clasificacion del sistema GRADE), el uso de intervenciones no farmacologica reduce la frecuencia de bacteriuria asintomatica (RR 0.67; IC95%: 0.48-0.94; 7 estudios) o de eventos adversos menores (RR 0.84, IC95%: 0.74-0.96; 2 estudios), pero no disminuye la tasa de infecciones sintomaticas del tracto urinario (RR 0.90; IC95%: 0.61 a 1.35; 4 estudios), ni mejora las puntuaciones de calidad de vida (escala MD -0.01 EQ-5D, IC95%: (-0.03)-(0.01), 1 estudio). Conclusion. El uso de intervenciones no farmacologicas durante la insercion del cateter urinario no supone riesgo alguno y si podria ayudar a disminuir la frecuencia infecciones asociadas a este procedimiento, tales como la bacteriuria asintomatica y eventos adversos menores; sin embargo, hay poca evidencia, y de baja o muy baja calidad, para llegar a conclusiones sobre su efectividad. EnglishIntroduction: Catheter-associated urinary tract infections (CAUTI) account for up to 30% of hospital-acquired infections. In this regard, several studies have reported the use of non-pharmacological interventions during urinary catheter insertion aimed at reducing the occurrence rate of CAUTI. Objective: To assess the safety and effectiveness of non-pharmacological interventions during urinary catheter insertion aimed at reducing the risk of contracting infections in non-immunocompromised adults. Material and methods: A literature review was conducted in the MEDLINE, Embase, and LILACS databases. Only randomized clinical trials comparing the use of non-pharmacological interventions to placebos, pharmacological interventions, or no intervention during catheter insertion were included. Results: Eight studies were retrieved (8 718 participants). Based on the evidence found in the review (low-quality and very low-quality evidence according to the GRADE system), using non-pharmacological interventions reduces the frequency of asymptomatic bacteriuria episodes (RR: 0.67, 95%CI 0.48-0.94; 7 studies) or mild adverse events (RR: 0.84, 95%CI 0.74-0.96; 2 studies), but does not reduce the occurrence rate of symptomatic urinary tract infections (RR: 0.90, 95%CI 0.61-1.35; 4 studies) or improves quality-of-life scores (MD –0.01 EQ-5D scale; 95%CI (-0.03)-(0.01), 1 study). Conclusion: The use of non-pharmacological interventions during urinary catheter insertion does not pose any risk at all. Instead, it could help reduce the occurrence rate of infections associated with this procedure, such as asymptomatic bacteriuria and mild adverse events. However, there is very little evidence (in fact, low and very low-quality evidence) to make conclusions on the effectiveness of these interventions.

revista de la facultad de medicina

Use of non-pharmacological interventions during urinary catheter insertion for reducing urinary tract infections in non-immunocompromised adults. A systematic review